A character goes mad from a sound that only they can hear. Because of this, they may go Ax-Crazy and try to destroy the source of the sound, or at least what they think is the source of the sound — or end up resorting to Headphones Equal Isolation, abandoning the world in favor of just getting away from the horrible noise.

Examples

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Anime and Manga

Joshua in Chrono Crusade gets the telepath variant when he gets Chrono's horns stuck on his head. He complains about "the noise" and uses his new powers to "stop the time" of the people around him, freezing them in stone.

Cromartie High School had a chapter of the manga, also adapted into the anime, which completely centered on the entire school trying to figure out what one song stuck in Hayashida's head was.

Code Geass: Mao was driven mad by the constant thoughts of everyone around him. He wore headphone to block it out. This made him a yandere for C.C. because she was the only person whose mind he couldn't read.

In Yu-Gi-Oh! Yami Yugi gives this as a punishment to a karaoke-obsessed bully after he loses a Shadow Game to him.

Soul Eater: Stein has something like issue in the anime whilst he's with Medusa.

In Higurashi: When They Cry, it's not uncommon for one of the characters to start hearing footsteps, or occasionally a voice saying "I'm sorry" over and over. This is usually a sign that that said character is about to go off the deep end. Most of the time someone ends up dead. Much to the unhappiness of the being that was making the footsteps and apologizing.

Comics

In a Judge Dredd strip paying Homage to The Tell-Tale Heart, a jealous man who murders and, literally, steals the heart from the lover of a woman whom he adores from afar is driven insane by the sound of his victim's still-beating heart, which he then decides to get rid of by returning the body part to the woman in person (and, consequently, completely freaking her out).

Fan Fiction

In a The West Wing fanfic called "The Joshua Monologues," Josh gets revenge on CJ, Sam, Toby, and President Bartlet after a prank gone bad by getting devices from the CIA which will beep very faintly (so only the prankees will hear them) and putting them in his coworkers' respective offices.

ThisYu-Gi-Oh! fanfic involves Ryou Bakura being pulled into a Shadow Game revolving around stopping every clock in the house, leading him to note how similar they sound to bombs.

Film

Gaslight is an inversion of this trope. One character tries to convince another that the light isn't flickering, it's just them going crazy.

Cameron Vale, the hero of Scanners, has to tell a telepathy-suppressing drug in order to go out in public or even sleep in his hotel room, because the thoughts of everyone around him are too much to handle, and as explained toward the beginning, the constant telepathy all his life has basically stopped him from developing any sense of self, turning him into a complete dysfunctional wreck. In the backstory of the film's villain, Darryl Revok, we learn that he went mad from it, and there's a taped conversation where he insists that it's not just voices in his head, but entire people, and he drills a hole in his forehead trying to get them out.

In A Christmas Carol Goes Wrong Scrooge's opening monologue has him bedeviled by a clock and its chimes, feeling it's always staring at him.

In Hook, despite having killed and stuffed the crocodile Hook is still afraid of the sound of ticking clocks. It's later revealed that he's scared of time ticking away.

Folklore and Mythology

The deathwatch beetle got their name this way. The beetles are woodboring and lay their eggs on wood so their larvae have something to eat. To attract a suitor they tap or tick against the wood, which is usually ignored day to day as it's fairly soft. However, on silent nights, such as when a family waits for someone to die, the noise is not drowned out. Hearing a ticking noise while you wait for death is not pleasant.

In one of the short stories from Everything's Eventual, a maître díhôtel flips out and starts killing people, while shrieking about a barking dog that only he can hear. Or possibly one that had barked at him once years ago. It's a little word salad-y.

In another book Insomnia, the main character Ralph can hear a soft ticking in his head which he calls the "deathwatch" when a person is about to die. He first heard it when his wife was dying of brain cancer. Near the end of the novel Ralph hears the deathwatch again, and knows that this time it's counting down for him.

In H.P. Lovecraft's The Rats in the Walls, the hero starts going crazy because he keeps hearing rats within the walls. Of course that's just the beginning, and it gets a lot weirder from there.

Inverted in the Doctor Who novel The Clockwise Man, everyone could hear the ticking except Repple because he's the robot making the noise.

Aquaphobic villainess Queen Tsarmina of the Redwall series is driven to insanity by the sound of dripping water, which her minions assume are the normal noises from the underground lake. Subverted in that it's not her imagination; the good guys have dammed the river and are causing said lake to overflow and slowly flood the castle. Also, in the same series, Gabool the Wild is kept awake by the sound of a stolen church-bell in his hall ringing on its own, though on one occasion it's not his imagination; his drunken followers throw apples at the bell while he's out of the room.

Then the noise goes away, and Tsarmina is at peace; except the reason it's gone away is that now it's not just dripping, there's too much water for that.

In Brain Twister (aka That Sweet Little Old Lady) by Randall Garrett and Laurence M. Janifer, telepaths invariably go mad from the voices. Most of them wind up comatose or raving — the one notable exception being the little old lady in the title, who would be able to easily pass for sane if she didn't keep confiding in people that she's actually Queen Elizabeth I.

In the Jedi Academy Trilogy, Luke seeks out a Force-Sensitive hermit, Streen, to recruit for his academy. Streen agrees to leave only if Luke teaches him to block out the thoughts and feelings of other people, which had overwhelmed him into hermitude.

Arthur C. Clarke's Childhood's End has the invading aliens' ambassador explain to the Earth Ambassador the useful application of energy capable of ending nations by comparing the results of the assassination of a hypothetical dictator to simply causing an unceasing, constant ticking noise within his head.

In the first Gaunt's Ghosts novel something like this occurs, with some twists. The noise is the beating of drums, and everyone can hear them. The drums in question are set up by Chaos cultists and number in the hundreds. Prolonged exposure to them cause the Ghosts that are nearby to lash out violently, and one of them is corrupted by Chaos as a result.

Live-Action TV

Mr. Heckles on Friends. It must be noted that the level of noise isn't in in his head, it's more of a case of Malevolent Architecture creating absolutely teethgrinding acoustics.

In "The One Where They're Up All Night", Phoebe is kept up by her fire alarm beeping. She smashes it and it still beeps. She puts on earmuffs and a hat to drown out the noise and also tries throwing it out.

In the 2007 finale of Doctor Who, the Master claims to have been hearing the sound of drums in his head all his life from when he was 8. Duh-duh-duh-DUM. Duh-duh-duh-DUM. It's interesting to note that he seems to like it, the way you can like something you've had all your life. He doesn't know what he'd be without that sound. When he's revived during "The End Of Time", he says he's missed the drums.

In the finale the 2009 series, it's revealed that he wasn't just insane, the Time Lords put the drumming in his head as part of a plan to try and save themselves from death in the Time War. It's noted that the rhythm of four drumbeats is the same rhythm as the double-beat of a Time Lord's two hearts. Interestingly, it's also the same underlying beat found in the famous Theme Song, so one wonders if that was intentional...

In Heroes, the ticking clock sound effect that plays whenever Sylar's up to his old tricks evokes this trope. Even though it's not literally a ticking he can hear, it symbolizes that he can see how everything works in a way no one else can, which drives him batty.

The song "All Along the Watchtower" does this to four Cylons at the end of Battlestar Galactica's third season.

In the televised miniseries I, Claudius, Caligula goes mad, partly due to the sounds of running horses which only he can hear. (The series implies he was nuts from the beginning, and only got worse after he suffered an illness.) Caligula himself claims that, as a god, he hears many things that keep him from sleeping, and that's one reason he acts so strangely.

Star Trek: The Next Generation. An alien (disguised as a human) plants the sound of a music box in Counsellor Troi's head so she won't be able to detect him with her empathic abilities. The sound drives her to madness, so he removes it once his identity is revealed.

The beeping that Freddy hears in the back of his head in the "iGoToJapan" episode on iCarly. He doesn't know it, but the beeping is the tracking device in action that Mrs. Benson had implanted in his head when he was a baby.

An episode of Tales from the Crypt had Danny DeVito as a crooked night club owner who murders a reporter (Fran Drescher) who threatens to expose him; shortly afterwards, his conscience starts nagging him that everyone will find out. Sure enough, he goes out into the club and everyone is staring at him, causing him to confess. It turns out, all they were staring at was the bloody wad of tissue paper and Q-tips he shoved in his ear to try and silence his conscience.

SCP-472 ("The Bloodstone"). Anyone within 18 meters of SCP-472 will hear the distant beating of their own heart. Listening to the heartbeat causes negative psychological symptoms. The longer the subject listens to the heartbeat the worse the symptoms become, starting with unease, anxiety and guilt and eventually leading to paranoia, hallucinations and catatonia (with a 76% chance of death).

Tabletop Games

When the Tyranids of Warhammer 40,000 descend on a world, they cast a "shadow in the Warp" before them strong enough to incapacitate or kill any nearby psykers: "They are coming! I feel them scratching inside my mind, scratching, screaming, roaring, so many, so, so many voices. They're coming for us flesh and blood, body and soul!" Since psykers are the key to interstellar travel and communication, a planet under Tyranid attack is effectively isolated and thoroughly boned.

Theater

Several stage adaptations of A Christmas Carol play up the ticking clock aspect to show Scrooge is getting on in his years and the limited amount of time he has to change.

Video Games

In the backstory of NieR, hearing bells ringing in your ear is a sign that the White Chlorination Syndrome is driving you mad, and you'll soon turn into Legion.

During the "Overlord" DLC for Mass Effect 2, a giant polygonal head keeps popping up on computer screens and making this awful noise. It sounds like gibberish at first, but grows clearer with each repetition, until you realize it's the lead scientist's autistic brother begging for someone to help him. The constant sensory input from the rig he's hooked up to has really done a number on him.

In an episode of Disney's The Legend of Tarzan, Tarzan's animal friends go crazy, complete with the Madness Mantra "Stop the ringing!" Turns out the local trading post had installed a long-range radio tower, and something in the equipment was generating an ultrasonic noise that was doing this to Tantor, Terk, and the rest. The humans couldn't hear it, but it was driving the animals nuts for miles.

Popeye did this in the short "Me Musical Nephews", destroying a radio before discovering that his nephews weren't really asleep.

Mr. Krabs in the SpongeBob SquarePants episode "Squeaky Boots". He unloads a pair of old boots on SpongeBob and is driven crazy by their constant squeaking. He steals them one night and hides them, but then he starts to hear squeaking everywhere until he is driven to madness, a Whole Plot Reference to Tell-Tale Heart.

A water faucet in the late 40's Donald Duck short Drip Dippy Donald, and an alarm clock in the Mouse Works-era Hickory Dickory Mickey.

Peter Pan: Captain Hook has a literal panic attack whenever he hears the ticking of a clock...coming from the belly of a crocodile who wants to eat him. Granted, not only is this a pretty good reason to panic, but others can hear the ticking, too.

Real Life

Tinnitus. Not a mental disorder, but a physical one, usually as a result of damage to the ear(s), though there can be other causes (the best being earwax impaction, as it is 100 percent curable). If you're lucky, the ring/buzz/hum/echo in your ears won't be that bad and it won't be omnipresent - making it a Most Annoying Sound but nothing worse. If you have moderate to severe tinnitus though, the ring/buzz/hum/echo is constant for all of your waking hours and/or is so loud that it interferes with your ability to converse, to hear anything other than it, and even to function. Severe tinnitus is quite capable of driving people to suicide, and worse is when someone doesn't recognize it as a physical disorder and assumes it is the onset of hallucinations, resulting in bad treatment that doesn't work to help the tinnitus.

This trope is why acquiring an unpleasant musical Ear Worm is so annoying.

While Hearing Voices is the trademark auditory hallucination of (especially paranoid) schizophrenia, it is not the only one. Clattering, ticking, low-rumble near-inaudible whispers or grumbles, animal noises of animals that cannot possibly be around, sirens/horns, and beeps are among the many others that can present.

Perfect pitch or a sensitive ear for music can be this, with the omnipresence of music in most places and that perfect pitch or a sensitive ear for mistakes can make anything from phone hold music to bad karaoke singers to that popular EDM song playing everywhere composed by someone most definitely lacking perfect pitch grating and annoying.

Some people have such sensitive hearing that they can hear their own heartbeats or blood rushing in their heads or that everyday noises are painful. This is common on the autism spectrum and pervasive development disorder, and is called sensory integration disorder.

A bug stuck in the ear can do this. Buzzing and moving about makes noise, until the bug dies (and often blocks the ear canal leading to temporary deafness until removed) or is removed.

Feedback in headphones that are shorting out/have the cord or jack exposed to extraneous electromagnetic fields can do this - technically other people can hear it, and it ends when you take off the headphones, but if they are your only set of headphones or you have to work with the feedback going it can be very much like this, often making your work (especially if it involves hearing anything but the feedback) difficult to impossible.

Metronomes, though they can (if your headphones are off anyway) be heard by others. There is a reason producers, programmers, and even drummers tend to turn them off, because they are so distracting they can make it impossible for you to keep your own rhythm while trying to stick to the metronome's, especially if you are working in Uncommon Time and can't set the metronome properly to your time signature, and that constant tick is very tiring to hear.

Dripping taps or repetitive banging noises such as from "air hammer" in pipes or a roof shingle that constantly flaps can be this, until they are repaired.

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